Individual provider Active NPI

Kimberly Lorraine McMurtrey, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1528209269
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18009 Issued in TN
Practice address
154 W Springbrook Dr
Suite 154
Johnson City, TN 37604-1758
Phone
(423) 975-6656
Fax
(423) 975-6657
NPI assigned
Mar 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18009 TN Primary

Addresses

Primary practice location

154 W Springbrook Dr
Suite 154
Johnson City, TN 37604-1758

Mailing address

154 W Springbrook Dr
Suite 154
Johnson City, TN 37604-1758
Phone (423) 975-6656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140822001538 TN Order and Referring Only - Nurse Practitioner 5991923583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18009TNMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1528209269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 W SPRINGBROOK DR",
            "address_2": "SUITE 154",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041758",
            "telephone_number": "423-975-6656",
            "fax_number": "423-975-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 W SPRINGBROOK DR",
            "address_2": "SUITE 154",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041758",
            "telephone_number": "423-975-6656",
            "fax_number": "423-975-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMURTREY",
        "first_name": "KIMBERLY",
        "middle_name": "LORRAINE",
        "name_prefix": "Mrs.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-10",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.